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I have had type 1 diabetes for 20 years myself. I caught a viral infection, and six weeks later I was in the emergency room because I had gone (temporarily) blind. What actually had happened was my blood sugar levels were so high that the fluid in the lenses of my eyes had almost congealed. I don't have type 2 diabetes, but many type 2 diabetics discover their problem the same way, by waking up in the ER and being told that they are in diabetic ketoacidosis, severely dehydrated and severely hyperglycemic.

It used to be that most type 1 diabetics died young. They took insulin with huge needles and syringes that had to be sterilized between uses. That created lots of opportunities for blood-borne infections. Insulin was not universally available, and it came in a "one size fits all" dosage. Nearly all diabetics got 40 units a day. They were then expected to eat exact amounts of protein, carbohydrates, fat, and calories at every meal. There was no way to do accurate testing. Diabetics could only know that their sugars were very high (by a urine test, using test strips dipped in the urine) or by keeling over. Unfortunately, many comatose diabetics were consigned to drunk tanks in jails and died there.

For about 25 years, diabetics have had access to glucometers they can use at home. It's possible to detect highs and lows before they happen. Insulin syringes are almost painless, and can be thrown away after one use. Even more importantly, "tight control" of blood sugar levels reduces the severity of complications. Diabetics still get heart disease, neuropathy, kidney disease, cataracts, and the like, but they get them much later and they live much better along the way.

Physician and diabetes expert Richard Bernstein had type 1 diabetes for over 70 years. He developed severe complications along the way, but overcame them. This was in 1969, over 45 years ago. Diabetics don't have to die of the disease early. They can live about as long as anyone else, but there are certain things they have to do.

  • Any type 1 diabetic, and any type 2 diabetic, has to do blood sugar testing several times a day. This means test when you get up, test after breakfast, test after lunch, and test after dinner and snacks (about 1-2 hours after meals). You have to get over any squeamishness and just do it. You can't guess what your sugars are and manage your diabetes well enough to avoid complications. Test, test, and test some more, and use the numbers as a guide to change what you eat and to eat the right foods in the right amounts when you exercise. Ideally, as unlikely as it may sound, the idea is to keep blood sugar levels between 70 and 90 mg/dl (4-5 mmol/L) at all times.
  • Natural treatments are fine, but they are never a substitute for medication. Moreover, there is no substitute for injected insulin (and there is no such thing as an "insulin pill," although inhaled insulin is available in a few markets). Even if you have to take insulin 3 to 5 times a day, you are better off because the improved blood sugar control helps you avoid hypoglycemia, hyperglycemia, passing out, going into ketoacidosis, accidents due to low blood sugar levels, and all the dreaded diabetic complications.
  • Type 1 diabetics tend to do better on insulin pumps than on insulin injections. However, the pump has to be supervised by an endocrinologist (other kinds of doctors don't do this) and it is absolutely, positively necessary to measure carbohydrates and stick to your diet if you use a pump. The advantage of the pump is there are fewer ups and downs of blood sugar levels if the pump is used correctly, fewer accidents, fewer episodes of memory losss, and fewer complications. Some of the newer pumps also measure blood sugar levels.

It is always better to treat diabetic complications earlier rather than later. Even after diabetes causes permanent damage, it still helps to keep blood sugar levels in control. You will live longer and feel better if you do.

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